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2021 Virtual Fall Games Registration
Form Note
Do not register until you are ready to submit your scores/results. All information and results should be entered at the same time. The deadline to submit the results is September 24, 2021 at 5 p.m.
Personal Information
Athlete Name
First Name
Last Name
Email
Phone Number
Birthdate
Enter your birthdate by selecting the box, then choosing your birthdate from the calendar. This is used to help division you properly in competition.
Age
Enter your age as of September 24, 2021.
Gender
Gender
Female
Male
Other Gender Identity
Select an athlete category
Participant Category
?
Select your participant category
SOMI Athlete (age 8-99)
Unified Partner
Unified Pair: Teammate name
If you are a Unified partner, please enter the name of the athlete you are competing with.
Delegation
?
Select your delegation
Unified Champion Schools
Area 1
Area 2
Area 3
Area 4
Area 5
Area 6
Area 7
Area 8
Area 9
Area 10
Area 11
Area 12
Area 13
Area 14
Area 15
Area 16
Area 17
Area 18
Area 19
Area 20
Area 22
Area 23
Area 24
Area 25
Area 26
Area 27
Area 28
Area 29
Area 30
Area 31
Area 32
Area 33
Area 34
Area 35
Area 36
Area 38
Area 39
Unified Champion School Name
If you selected Unified Champion Schools as your delegation, please list your school here.
Choose your activities
Select up to three (3) activities. Once an item is checked, a results section will appear underneath the list of activities where you will enter your result(s).
Cycling: 250m
Cycling: 1K
Cycling: 5K
Fitness: Push Up
Fitness: Sit Up
Fitness: 6-Minute Walk
Results
1K Results: Minutes
minutes
1K results
1K Results: Seconds
seconds
250m Results: Minutes
minutes
250m results
250m Results: Seconds
seconds
5K Results: Minutes
minutes
5K Results
5K Results: Seconds
seconds
Push Up Results
Total push-ups in 60 seconds (traditional). If entering for a Unified pair, enter your total combined push-ups for both competitors.
Push Up Results Modified
Total push-ups in 60 seconds (modified). If entering for a Unified pair, enter your total combined push-ups for both competitors.
Sit Up Results
Total sit-ups in 2 minutes. If entering for a Unified pair, enter your total combined sit-ups for both competitors.
6 Minute Walk Laps
laps
Photo upload
Have a photo of you competing in the Virtual Fall Games? Share it with us by uploading it.
One file only.
16 MB limit.
Allowed types: gif, jpg, png.
Video upload
Have a video clip of you competing in the Virtual Summer Games? Share it with us by uploading your video.
One file only.
64 MB limit.
Allowed types: mov, mp4.
Participant Waiver and Release
In order to participate in the Virtual Summer Games, you must read and agree to the waiver for online activities.
Click here for waiver details
I hereby enter into the following agreement with Special Olympics International and/or Special Olympics Michigan as well as its members, officers, employees, agents, and representatives (individually and collectively, “Special Olympics”), as a condition of receiving and using Special Olympics’ online fitness, sports, leadership and inclusion programming services.
I acknowledge and fully understand that Special Olympics will endeavor to provide the most effective principles to help achieve my fitness, performance, and personal goals, but that Special Olympics cannot guarantee that any services, products, programs, methods, workouts, recommendations, or routines will be safe, effective or suitable for everyone. All such products and services, programs, techniques, recommendations, and materials embodied in such products and services are offered without warranties or guarantees of any kind, express or implied, including, but not limited to, warranties of safety or fitness for any particular purpose.
Further, I hereby waive, release, and discharge Special Olympics and all of their members, officers, employees, agents, and representatives from any and all liability from death, injuries or damages arising from, or in any way connected with, use of its services, products, programs, methods, workouts, recommendations, or routines, including any death, injuries or damages resulting from the negligent recommendations, acts, or omissions of Special Olympics, no matter where those injuries occur.
I acknowledge and fully understand that any fitness or exercise activities, and the use of training and fitness equipment and machinery, involve risks of serious injury, permanent disability, or death, even if done correctly and with the utmost attention to safety. These risks include, but are not limited to, fainting; broken bones; strained or torn muscles; torn or strained ligaments, tendons, and other connective tissues; herniated discs and other spinal injuries; cardiovascular or cerebrovascular events, including heart attack or stroke; conditions related to overexertion, including heat stroke/exhaustion or rhabdomyolysis; or damage to the nervous system, including irreversible damage to the brain or spinal cord. I further acknowledge and fully understand that participation in any fitness or exercise activities could aggravate a pre-existing condition, whether known or unknown, and that there may be other risks associated with my participation in fitness or exercise activities that are not known or not reasonably foreseeable at this time. I further acknowledge and fully understand that all of the foregoing risks are especially pronounced in an online programming setting, such as that embodied by the fitness and performance programming services provided by Special Olympics because I will necessarily be engaging in fitness or exercise activities on my own, without real-time supervision by Special Olympics, in a facility or location over which Special Olympics has no control.
I hereby acknowledge and accept the foregoing risks and dangers. Further, I hereby waive, release, and discharge Special Olympics from any and all liability from death, injuries or damages arising from, or in any way connected with, Special Olympics’ fitness and performance programming services; Special Olympics’ instruction, programming, advice or recommendations; the use of any exercises, routines, equipment or machinery, whether or not they were recommended by Special Olympics; or my engagement in any fitness or exercise activities, including any death, injuries or damages resulting from the negligent recommendations, acts, or omissions of Special Olympics, no matter where those injuries occur.
I acknowledge and understand that
Special Olympics and all of their members, officers, employees, agents, and representatives may not be licensed dietitians or physicians,
and do not hold themselves out to possess professional expertise in dietetics or medical matters. I acknowledge and agree that any information, guidelines, or advice provided by Special Olympics are not intended to constitute and shall not be construed as dietetic or medical advice, as treatment for any general or particular medical or physiological condition or pathology, or as a means of improving or bettering health outcomes, and that they carry no express or implied warranty of any kind, including, but not limited to, warranties regarding safety or suitability for a particular purpose.
I understand that a physician’s approval is highly recommended prior to participating in any type of fitness or exercise activity
, and I hereby represent that I have either obtained a signed approval from my physician, or that I acknowledge the risks inherent in such activities but have elected to engage in said activities without seeking prior approval by a physician.
If a court of competent jurisdiction, or any other legal authority or governmental agency, declares any provision of this agreement invalid, such invalidation shall not affect the remaining provisions of this agreement, which shall remain in full force and effect. If any sentence, clause, phrase, or term of any section of this agreement is deemed invalid, the remainder of that section shall remain in full force and effect.
Any suit brought under this agreement, or in relation to any programming, consultation or services provided under this agreement, shall be brought in Michigan or in the District of Columbia, and both parties irrevocably consent to venue and jurisdiction in that court. This agreement shall be governed by Michigan or District of Columbia law, irrespective of any choice-of-law principles. The parties’ legal rights and obligations relating to this agreement and relating to the programming and services provided under this agreement shall be governed by Michigan or District of Columbia Law, irrespective of any choice-of-law principles. This agreement shall be deemed to have been agreed to and executed in Michigan or District of Columbia.
I hereby give permission to Special Olympics and any of its employees, contractors, coaches, or representatives to use my name and photographic/video likeness in all forms to spread the mission and objectives of Special Olympics and for use in media for advertising, exposition displays, trade, and any other lawful purposes.
I HAVE READ THIS AGREEMENT IN ITS ENTIRETY AND AGREE TO ADHERE TO ALL ITS PRECEPTS.
Any questions that I may have had relating to anything in this agreement have been answered to my satisfaction. This document encompasses the entire agreement of the parties and supersedes all prior oral and written representations between the parties, if any.
Waiver Agreement Confirmation
Check the box above if you agree to the terms of the waiver for online activities.
Leave this field blank
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